Childhood Onset

There have been many questions surrounding the diagnosis of bipolar
disorder in children because of the difference in symptoms they exhibit
compared to that seen in adults with the disorder. This is mainly due to
the differences in the manic state of bipolar children in contrast to
adults. While adults have a manic state characterized by extremes in
emotion and happiness, children show outbursts of aggression and
irritability. This difference separates the symptoms of the disorder in
children and adolescents. Symptoms are mixed in young children, while
older adolescents have the common adult-like mood swings.

The difficulty in diagnosing a child as bipolar, is that symptoms such
as irritability and hostility are also characteristics of attention
deficit hyperactivity disorder (ADHD), conduct problems, and even
schizophrenia. Another important factor upon the illness being overlooked
surrounds parents’ inability to recognize the warning signs and equate
the irrational change in behavior as anything more than “phases of
growing up.”

While the diagnosis may be difficult, most research points to the
diagnosis of a childhood-onset bipolar disorder to be different than that
of an adult. Some research has even indicated the number of children
diagnosed with bipolar disorder is increasing over those first diagnosed
with adult form. In fact as many as 45 % of adults suffering from bipolar
disorder believe they first showed signs of the illness as children.

Symptoms that characterize childhood and adolescent bipolar disease are
sometimes confused or associated with other diseases.

Children:

Language disorders

Attention deficit hyperactivity

Conduct and defiant disorder

Sexual abuse

Anxiety problems

Adolescents:

Attention deficit hyperactivity disorder

Conduct and defiant disorder

Sexual abuse

Schizophrenia

Anxiety problems

Substance abuse

These traits carry with them different
circumstances and should be dealt with appropriately
given the severity. Conduct disorders is similar in
both age groups, with occurrence being in about 20 %
of those afflicted. Understanding the family history
is important in determining sexual abuse and
possible schizophrenia. Attention deficit disorders
usually lead to bipolar disorder in both children
and adolescents characterized by recurring states of
mania. Substance abuse in adolescents often leads to
rapid cycling and can mimic the negative effects of
depression and mania throughout. Both children and
adolescents have higher instances of anxiety, with
as many as 30% of all sufferers facing this threat.

The Course of Bipolar Disorder through Age

Childhood and Young Adolescent

Initial Episode:

Strong depression

Type:

Rapid-cycling

Length of illness:

Continuous

Lasting Symptom:

Manic State

Teenagers

Initial Episode:

Heightened mania

Type:

Extreme highs and lows

Length of illness:

Days or weeks

Lasting Symptom:

Depressed state

Young children are usually stricken with an
episode of depression and sadness, usually resulting
in cycles of irrational behavior and brief
outbursts. The illness is continuous until treated,
and it is the manic state that usually remains the
toughest to overcome. While there are improvements
in teenagers who suffer from the illness, young
children often face the fact that the disease is not
going to go away, and may in fact plague them into
adulthood. The ability to diagnosis the disorder in
its early stages, and seek appropriate treatment
that will help regulate the child’s behavior can in
most cases keep it regulated, and even reduce its
debilitating effects before adulthood.